Antibiotic Prophylaxis during Extracorporeal
Shock Wave Lithotripsy (ESWL) in the
Prevention of Urinary Tract Infections in
Patients with Sterile Urine before the Procedure
Behrouz Ghazimoghaddam, Hamidreza Tajari, Mahnaz Gholipoor, Morteza Balmehd
Dr Behrouz Ghazimoghadam
Assistant professor of Golestan University of Medical Sciences
Urology department, 5 Azar Hospital, 5 Azar boulevard,
Gorgan, Golestan province, Iran
Introduction: There are controversies in the literature regarding the need and the duration of antibiotic prophylaxis in patients with extracorporeal shock wave lithotripsy (ESWL), who had a negative urine culture before the operation. This study was performed to evaluate the efficacy of the antibiotic prophylaxis in patients with proven sterile urine before they underwent ESWL.
Materials and Methods: In this clinical trial, 150 patients with renal or urethral stones and sterile urine were examined for bacteriuria (positive urine culture) following ESWL. These patients were classified into 3 groups which received either asingle dose of oral co-trimoxazole (Tab, 400/80 mg)- group A, a single dose of nitrofurantoin (Tab:100mg) -group B and no treatment- group C. Patients were followed with urine analysis and urine culture after two weeks.
Results: The occurrence of post-ESWL urinary infections (positive urine culture) was 14% in group A, 10% in group B and 14% in group C. The complications among the groups were not statistically significant.
Conclusion: The incidence of urinary tract infections after ESWL is extremely low, provided that in patients who had sterile urine before ESWL, prophylaxis antibiotics do not seem to be necessary.
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